Exploration of a Web-based accessibility tool for public facilities

Gunilla Carlsson (Department of Health Sciences, Lund University, Lund, Sweden)
Oskar Jonsson (Department of Health Sciences, Lund University, Lund, Sweden)
Stefan Olander (Department of Construction Management, Lund University, Lund, Sweden)
Marianne Salén (Tillgänglighetsdatabasen, Västra Götalandsregionen, Skövde, Sweden)
Eva Månsson Lexell (Department of Health Science, Lund University, Lund, Sweden and Department of Neurology, Rehabilitation Medicine, Memory Clinic and Geriatrics, Skåne University Hospital Lund, Lund, Sweden)
Björn Slaug (Department of Health Sciences, Lund University, Lund, Sweden)


ISSN: 0263-2772

Article publication date: 29 June 2023

Issue publication date: 18 December 2023




This study aims to explore how an accessibility database (AD) has been developed and implemented as a tool for facility managers to evaluate and increase the accessibility of public facilities.


Eight participants were strategically sampled for semi-structured interviews, and documents on the AD were gathered. The Consolidated Framework for Implementation Research (CFIR) was used for a directed content analysis of the data. The CFIR domains used for the analysis were: intervention characteristics, outer setting, inner setting, characteristics of individuals and process.


The development and implementation of the AD demonstrated the complexity in assessing and planning for increased accessibility. The communication and iterative processes within the inner as well as with the outer setting was an important part of the development and implementation, as well as anchoring each step locally, regionally and nationally, within public authorities and disability organizations.

Practical implications

The assessments of environmental barriers and the results reported in the AD can serve as a guide for identification of accessibility issues. However, singular identified barriers were reported as a fragmentation of the building regulations, and thereby when retrofitting is carried out, experts who have the competence to suggest solutions based on the entirety need to be involved to reach the goals of increased accessibility and countering of exclusion and discrimination.


By structuring the implementation process by means of the CFIR, facilitators and barriers of using an AD as a basis for retrofitting were revealed. The practical challenges outlined in assessing and increasing accessibility can guide facility managers when considering actions to increase accessibility.



Carlsson, G., Jonsson, O., Olander, S., Salén, M., Månsson Lexell, E. and Slaug, B. (2023), "Exploration of a Web-based accessibility tool for public facilities", Facilities, Vol. 41 No. 15/16, pp. 66-84. https://doi.org/10.1108/F-10-2022-0132



Emerald Publishing Limited

Copyright © 2023, Gunilla Carlsson, Oskar Jonsson, Stefan Olander, Marianne Salén, Eva Månsson Lexell and Björn Slaug.


Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial & non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

Accessibility of the built environment is a critical aspect when creating a socially inclusive society (Ormerod and Newton, 2005). The opportunity to move around and gain access to places is a prerequisite for having active members of society. This is well known, but still, individuals face accessibility issues in the public environment worldwide (Carlsson et al., 2022; Welage and Liu, 2011). To participate in society on an equal basis encompasses instrumental as well as non-instrumental aspects, for instance, safety, physical accessibility and usability (Iwarsson and Ståhl, 2003), aesthetics, meaning and emotional experiences (Desmet and Hekkert, 2007). By providing accessible facilities, the building sector play an important role in giving all people the same opportunities to participate in desirable activities on equal terms (Ormerod and Newton, 2005).

When focusing on intervening for more accessible facilities, environmental barriers must be removed, and the environmental demands should not exceed individuals’ functional capacity (Iwarsson and Ståhl, 2003). In 2019, the General Assembly of the United Nations (2019) adopted a resolution about accessibility to further implement the Convention on the Rights of Persons with Disabilities (UN, 2006). The resolution highlights the importance of accessibility measures and promotes universal design in the development of standards and guidelines (Article 4). Universal design practice – with more ambitious goals than just accessibility (Steinfeld and Maisel, 2012) – should therefore be an important part of facility management to achieve a barrier-free environment (Kristl et al., 2020). In Sweden, the physical environment is addressed in the Policy for Designed Living Environments (SFS 2017/18:110) (2017), but also products and services in the Accessibility Directive (SOU 2021:44) (2021). The goals are to identify and remedy existing accessibility issues as well as counteract discrimination [National Goal and Orientation for Disability Policy, SFS (2016/17:188), 2016].

1.1 Identify and remedy existing accessibility issues in public facilities

As stated above, it is not enough to describe barriers in the physical environment to meet the goal of remedying accessibility issues in public facilities. With the focus on accessibility, the environmental barriers have to be related to individuals’ functional capacity (Iwarsson and Ståhl, 2003), because the demands might be different for a person using a wheel chair (Welage and Liu, 2011) and a person who is blind (Jeamwatthanachai, et al., 2019). A recent scoping review of accessibility in public buildings (Carlsson, et al., 2022) demonstrated that out of 40 original scientific papers, 30 just used instruments/checklists targeting features of the physical environment, while the remaining ten also involved study participants to assess accessibility. The accessibility issues reported in the papers were related mainly to mobility, in some cases to visual limitations, while few addressed cognitive or hearing limitations, and all of them were descriptive. Thus, the papers did not focus on evaluations of measures to improve accessibility. In the scientific literature on public outdoor environments, there are examples of interventions being evaluated (Ståhl et al., 2008), but it is more common to identify facilitators and barriers in existing environments (van Hoof et al., 2020) or to focus on participants’ health aspects in existing (Gharaveis, 2020) or refurbished environments (Vert et al., 2019). More common for public buildings is to assess the compliance with the building regulation (Calder et al., 2018; Wu et al., 2007), without any intervention to improve the accessibility. In a paper by Michopoulou and Buhalis (2013), the need of personalized information for an accessible tourist sector was focused on, and data was collected through focus group interviews about user requirements. Based on this data, a platform that could provide information to tourists was drafted, while several challenges for such a platform also were acknowledged, for instance, the challenge to create a system that provides accessible, reliable and accurate information about accessibility. The type and amount of data about accessibility and environmental barriers vary between websites and in apps. For example, the Norwegian initiative “Bygg for alle” (BfA, “Build for all”, authors translation) (Aslaksen, 2016) provides information about wayfinding, possible barriers and display the places with several photos. For visitors, this is great, but for facility managers, more information is needed.

1.2 Study context

A Swedish user-driven initiative with the ambition to empower individuals to visit places and access services is the Accessibility Database (AD) (Tillgänglighetsdatabasen, 2022; Västra Götalandsregionen, Tillgänglighetsdatabasen and Göteborgs stad, 2015). In 2002, the tourism sector initiated the AD and the region-owned company developed it as a public database, which became available in 2005. Initially, the content of the platform was focused on tourism facilities, but some municipalities saw opportunities in using it for other facilities as well. In 2011, the region in western Sweden took over the responsibility for the AD, and the third and latest version was launched in May 2019. The development process has been characterized by the involvement of representatives of disability organizations, facility managers, national organizations and public authorities. The AD designates a structured query language (SQL) database with a Web-based interface (we will henceforth refer to it as a Web-based platform), and an associated organization with staff who are responsible for maintenance, support and development. The AD offers detailed information about the features of public facilities from the point of an accessibility perspective. Those considering visiting certain facilities can use this information and assess the level of accessibility in relation to their individual needs. From a facility management perspective, the AD aims to support facility managers to investigate environmental barriers in their facilities, and with the basic information they receive, enable them to plan for the removal of environmental barriers. It is up to each partner to decide what is to be inventoried within the contract. This means that property owners do not have their own agreements but are included in agreements with formal partners such as municipalities.

Ormerod and Newton (2005) argue that a lack of understanding from facility designers regarding how individuals with various disabilities interact with a building is a major barrier to increasing accessibility in the built environment. Unlike building regulations, which are regulatory tools to ensure compliance with minimum accessibility requirements, the AD items in the Web-based platform also include more comprehensive items that aim to increase the accessibility for various categories of visitors. Well-structured and specific information on how facilities meet different requirements from an accessibility perspective can therefore be instrumental in the complex process of investigating, analyzing, reporting, and intervening for more accessible facilities.

To learn lessons from the extensive work done on the AD, the purpose of the study reported here was to explore how an AD has been developed and implemented as a tool for facility managers to evaluate and increase the accessibility of public facilities.

2. Method

2.1 Design, sample and data collection

In this explorative and qualitative study, we applied a cross-sectional design, using interview and document data. A strategic sample of information-rich participants who had been in contact with and used data from the AD (Tillgänglighetsdatabasen, 2022) in different ways was recruited to participate in semi-structured interviews. A variation in the participants’ organizational affiliations and previous experiences was considered important. In total, eight persons, three men and five women, were recruited and interviewed. They were: one head of a real estate company, two facility managers, two municipality officials, one architect, one project manager and one urban planning consultant. The participants received written information about the study and made a verbal informed consent to participate, which was documented by the interviewer. The first author conducted the semi-structured interviews with open-ended questions, and the follow-up questions were dependent on the participants answers. The seven overarching themes were about:

  1. how the participant came into contact with; and

  2. used the AD, for example, assessed facilities, read AD reports and implemented measures.

Questions were also posed about:
  • (3) any facilitators;

  • (4) barriers identified when using the AD;

  • (5) met; and

  • (6) unmet needs; and

  • (7) what they considered most important for the future development.

The interviews were held digitally and audio recorded on a separate device. An external company transcribed the interviews.

Further, the AD webpage (Tillgänglighetsdatabasen, 2022), reports, assessment forms and information material (2011–2022) provided by the AD organization were used as complementary data to enrich and strengthen the analysis (Västra Götalandsregionen, Tillgänglighetsdatabasen and Göteborgs stad, 2015).

2.2 Data analysis

The data were analyzed by means of directed content analysis (Hsieh and Shannon, 2005). To understand if an intervention is successfully implemented or not, a theoretical framework can guide implementation research through data collection, analysis and interpretation of results. The Consolidated Framework for Implementation Research (CFIR) is such a theoretical framework, which Damschroder et al. (2009) developed through integrating previously published theories above all from the health-care sector into a single consolidated framework. The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of individuals and process. Each domain is built up of 4 to 14 constructs and subconstructs that can be used for the analysis of the domain. These five domains and the constructs of CFIR guided the analysis.

As a first step in the analysis, two of the authors separately coded two transcribed interviews according to the predefined domains and constructs, and then compared the results. Differences identified were mostly related to the wealth of aspects in the interviews that could be identified, that is, some content could be coded to several domains and constructs. The coding was discussed until disagreements were resolved and a consensus was reached. As a second step, the same two authors read the remaining six interviews and coded three each. Third, the complementary data of documents, reports, etc. was read through, and relevant text that added information to the interviews was coded by the first two authors into the framework. To increase the trustworthiness, the content of the information gathered was verified with the fourth author, who has been involved in the development process. Together with the third author, making sure the analysis procedure involved competencies in accessibility as well as building construction, coding of the interviews was in a fourth step thoroughly discussed, and a first version of the manuscript was drafted. To illustrate and bring content in the domains to life, quotes that constituted typical examples were selected. The results were presented to the other co-authors who provided critical intellectual input from their perspectives in an iterative process where the manuscript was progressively refined, and some quotes that elucidated the findings were chosen and translated.

3. Findings

The AD has been developed from focusing on information about environmental barriers in tourism facilities to cover public facilities in general, from information for visitors to guidance for the facility management sector. The findings from the interviews demonstrated the complexity in assessing and planning for increased accessibility. The importance of communication and iterative processes within the inner as well as with the outer settings were highlighted. The assessments of environmental barriers and the results reported are intended to serve as a guide for identification of accessibility issues. However, as reported, the building regulations focus on the overall functioning of the environment. To reach the goal of increased accessibility when retrofitting, participants reported that the entirety has thus to be considered, and experts with appropriate competence need to be involved to suggest solutions.

The findings are reported in line with the CFIR, so the subheadings under each section correspond to the domains and constructs of the CFIR (Table 1). The findings start with a description of the AD development in today’s Intervention characteristics (Section 3.1). Then external individuals and organizations interacting with the AD Web-based platform and staff are described as the Outer setting (Section 3.2). Further Characteristics of individuals (Section 3.4) in the Inner setting (Section 3.3) charged with implementing the intervention are described under each domain respectively and, finally, some of the incremental and spiral approaches for implementation are described as the Process (Section 3.5) (Figure 1).

3.1 Intervention characteristics

3.1.1 Intervention source.

In September 2022, data on approximately 9,000 inventoried facilities were available in the AD; three regions, 56 municipalities, two tourist organizations and seven other organizations (e.g. the Church of Sweden; pensioner’s and adult educational associations) were formal partners. Even if the partners’ organizational affiliation of the AD varied in the regions and municipalities with signed contracts, the facility management sector was a common affiliation.

Nowadays, the main target groups are:

  • citizens and visitors;

  • support for facility managers to identify interventions; and

  • politicians and decision makers.

In addition to information on the website, formal partners can receive various AD reports as a support for the analysis of barriers and planning of retrofits to make facilities more accessible.

The experiences of those participants who had been involved in the development of the intervention varied depending on where in the organizations they had been working. Some talked about it as an externally developed intervention, whereas others described how they had provided feedback and had sensed they made an impact on the development.

3.1.2 Evidence strength and quality.

The standard for environmental barriers in the AD items is based on Swedish building regulations, experiences from people with disabilities and facility management competence in the area. The participants reported that it has been important to anchor each step locally, regionally and nationally, in the development process within governmental and public organizations as well as disability organizations. Continuous formal AD user meetings have been held, and in an iterative process with the disability council, formal partners, facility managers, accessibility assessors, businesses and visitors. The AD has been developed with new AD report functions, knowledge support to businesses and continues to develop based on facility managers as well as visitors’ needs.

Depending on the purpose of the assessment and the facility, the number of items to assess varies. If measures are planned to be taken, the assessment form must be completed in full, which enables various AD reports. If the purpose is solely to publish information on the public website, fewer items need to be assessed, but then it is not possible to receive an AD report, which was expressed as a necessity for some participants. Furthermore, other AD reports have been developed, because formal partners want to be able to give separate feedback to facility managers and businesses.

In general, the participants were positive about the AD Web-based platform and organization. A consistent approach has been to continuously evaluate and incrementally develop the AD; however, due to the complexity of accessibility issues, challenges were reported. Some participants explained how the building regulations focus on the overall functioning of the environments and well-considered design solutions, whereas environmental barriers identified by means of the AD items are detailed accessibility requirements. Therefore, there might be challenges in assessing the items correctly. Some participants argued that, if measures were taken for resolving just a single barrier, the overall retrofit could become inadequate if they were not considered in a larger context. An example that was given was a toilet that was made accessible, but because the building’s entrance was not accessible, wheel chair users had no access the toilet. Participants reported that recommendations about features of physical access could also contradict other building regulations. For example, easily opened doors are necessary for people with upper extremity limitations, but heavy doors are installed due to fire safety. Therefore, some participants argued that it is important to ensure that the planning, design and construction processes consider the entirety. According to the participants, individuals involved in such processes must have a broad knowledge about human diversity and gain a deep understanding of the specific businesses, their visitors and conflicts of interest, so the design solutions to the greatest extent possible meet diverse user needs. The AD organization recommends that certified accessibility experts are involved in the interpretation of the AD reports because it is not possible to resolve the environmental barriers solely based on them.

3.1.3 Relative advantage.

A strength of the AD Web-based platform, identified among some participants, was the possibility to use the information for many potential target groups and for different purposes. Participants reported that the data can serve as a basis for analysis and planning for improvement of accessibility in existing and new facilities, as well as to provide competitive advantages and values for businesses. The formulation of AD items as predominantly objective measurements was described as an advantage because it reduces the risk of subjective and biased assessments and interpretations. However, some participants stated that there was room for improvement regarding measurability.

The AD reports were described as a strength, especially for facility management. According to one participant, the AD assessments allow an advantageous major overall view of all the region’s properties as opposed to regular work that usually focuses on delimited space. Participants also reported the possibility to identify areas where different criteria in building regulations are contradictory.

3.1.4 Adaptability and trialability.

The accessibility assessors can choose relevant sections to assess and base their choice on local conditions, and what they perceive as valuable information. When new types of facilities were identified, they could report and discuss them at AD user meetings. If they were prioritized, new assessment forms could be developed.

The AD reports offer different alternatives, due to the actual needs and local contextual factors at site. In one extensive retrofit project based on data from AD reports, several challenges appeared. One of the participants suggested that it is always best to start with a pilot project. Another participant reported on re-assessments that were undertaken several times with new directives each time, leading to issues for staff internally, the businesses and above all frustration for the contractors. According to some participants, skilled and creative staff with previous experience of similar challenges facilitates retrofit reasoning, professional judgment, trade-off balance and regulatory deviations to reach efficient solutions.

New partners can test the database, and if they are not satisfied, they can choose to not renew the agreements. Every year, a few new formal partners are added, and another few terminate their agreements.

3.1.5 Complexity.

Assessing and identifying environmental barriers in facilities that include everything from small shops to large zoos or sports halls is complex. In addition, complexity increases because the AD is targeting many potential organizational units (e.g. policy makers, facility managers, businesses) and categories of users (e.g. inhabitants, visitors, public sector, industry, property owners, politicians, decision makers and accessibility assessors) with diverse needs.

Complexity was also an issue when a barrier had to be removed. The barrier could be difficult to remove either due the extent of the retrofit or the number of organizations that needed to be involved. Participants indicated that some environmental barriers were complex to capture and interpret correctly in construction documents, such as light, sound and gradients. The consequences of retrofits and their inherent complexity were also reported for hygiene rooms and floors. If the sink should be lowered and the drain was in the wall, the drain needed to be moved, and the moisture barrier was broken. This drawback was also mentioned when alarm buttons were moved. Another example provided by the participants was about visual paving of tile floors. Tearing up parts of floors and laying new tiles could involve other problems in the future, and they therefore tried to find other solutions.

3.1.6 Design quality and packaging.

For formal partners, mandatory training is now given online. Tablets and smartphones are used for the assessments, and together, they have reduced the time for undertaking the assessments. Over time, the AD reports have been refined and become more automated and explanatory. For example, facility managers can receive AD reports on issues that need to be addressed to comply with Swedish building regulations or with the higher demands used for the AD items, and businesses can receive their AD reports.

Some participants, responsible for reducing the number of environmental barriers, wanted to have more information about prioritization in the AD reports and information on the context, pathways or visitors’ routes. Other participants argued that a group of experts need to be involved and, today, the AD organization recommends involving a certified accessibility expert. Before prioritizing, making decisions, and taking possible measures, the results from the AD reports need to be sorted out and interpreted, and issues put in context. The perspective of visitors, businesses and facility managers also needed to be taken into consideration, so information could be translated into practical terms and cost estimates. Site visits to gain a better understanding were also reported to facilitate good results.

Some participants mentioned that the AD reports and the supplementary guidelines can also be used for pedagogical purposes to inform the businesses to avoid creating environmental barriers, for example, with the inappropriate placing of flowerpots at entrances, signs on doors or things on service desks.

3.1.7 Cost.

The partners pay a fee every year for the AD and must have educated staff to do the assessments. Each partner chooses which forms they want to use. Large amounts of details in the assessments were reported as time-consuming, subsequent work were made expensive and difficult to implement within the regular organization. The formal partners had solved how to do the assessments in different ways due to local conditions. Some outsourced assessments as consultancy assignments. In other areas, as part of active labor market measures, the formal partners collaborated with the Swedish Public Employment Service in a win–win situation in which young people far from the labor market receive internships in working life. Experienced staff act as supervisors and assessments are made. When the mandatory training switched to being implemented online, the cost was reduced. Further, the cost difference depended on whether the partner was in a region running the AD or not, and on the size of the municipality or organization.

Costs associated with retrofits were also mentioned, for example, if it was necessary or even possible to rebuild when it was a minor deviation from a recommendation, such as when the height of a handrail deviated only slightly. Major retrofits were sometimes considered too expensive to be justifiable and sometimes impossible to undertake. For example, to raise a sink some centimeters. At the same time, one participant reflected that it was still a problem for individuals using a wheel chair to be able to get next to the sink.

Overall, the participants emphasized the importance of political anchoring and the will to reduce the costs. They also gave examples of reconstructions that did not meet the pre-specified accessibility requirements and one participant considered that a waste of money.

3.2 Outer setting

3.2.1 Client needs and resources.

According to some participants, facility managers expressed the need to work more strategically with measures to improve accessibility. One participant reflected upon property owners needing of computer-based systems that afford intuitive use, smart site-specific automation and cost-effective retrofit suggestions due to their lack of time and other resources. Yet, the staff at a hospital were described as hesitant to do retrofits, because it was considered to cause issues such as temporary reduced accessibility, clutter and disturbance.

3.2.2 Cosmopolitanism and peer pressure.

The development of the AD has been done in close collaboration with visitors, disability organizations, formal partners, facility managers, administrators, accessibility assessors and policy makers. During the early development phase of the AD, the disability council even suggested which facilities should be inventoried, including some facilities that were not publicly owned.

One participant reflected on the need to increase inter-organizational knowledge about the requirements with which they must comply and indicated that cross-sector spanning activities might promote a more holistic approach as opposed to a task-oriented one. Engagement in education of future professionals was mentioned as another way to transform knowledge and achieve changes in the longer term.

3.2.3 External policy and incentives.

The Swedish building regulations clearly state that public environments should be accessible and usable for people with diverse needs, but politicians were reported to have pushed accessibility issues from the top down to varying degrees in different regions and municipalities. In one region, there was a political decision that all their municipalities could become formal partners. In some municipalities, longstanding collaborations with disability organizations, advocating for use of the AD, influenced the imposition of assessments and which facilities to prioritize. Information on how existing facilities comply with building regulations might, however, be meaningful for politicians. Some participants thought it would be good if the responsibility for the AD was elevated to a national level. The participants reported that the legal requirements in different areas can be contradictory as well as the possibility that regulations and policy objectives might change over time. Some participants also reflected upon the knowledge and ability to apply the accessibility regulations among professionals designing and constructing buildings. They also found that many professionals and policy makers had not enough incentive to take measures, which generally impedes accessibility ambitions. Another challenge mentioned was the design of lifts because the accessibility requirements were not automatically included in new purchase orders and were difficult to change afterward.

3.3 Inner setting

3.3.1 Structural characteristics.

The approach with formal AD user meetings to have inner setting communication and workshops for continuous development and mutual learning has been important over the years. A consequence reported in all the discussions about retrofit projects was that the awareness of accessibility increased in the entire organization. The size of the organization using the AD was mentioned to be a decisive factor. Small- or medium-sized municipalities often have to work in project form to be able to manage it, which might be a challenge in maintaining continuity. Some participants reflected upon their experiences of implementing the AD, and the importance of having mandate and support from the executive director and other heads in the organization.

The progress with the AD reports was described as an important structural characteristic in terms of mapping the environmental barriers, but still there is a need for facility management to have competences that analyze and interpret the identified barriers and suggest measures. Lessons learned from an extensive retrofit project were that it was important to report and decide on project deviations in a formal manner.

3.3.2 Networks and communications.

The AD organization collaborates with various occupational specialties and interacts with many organizations, especially when analyzing and planning measures to increase accessibility (Figure 1). All participants highlighted the importance of informal and formal communication as well as professional judgment. For example, the property owner’s perspective is essential in the phases of analyzing, sorting, prioritizing, planning and designing, as they have knowledge of upcoming renovation plans, local needs, financial conditions, etc.

However, participants reported that some network organizations have other primary purposes than improving accessibility. For example, a parking space was rebuilt, and when the contractors focused on drainage and electricity in parallel with access, in a sustainable and cost-saving reconstruction, the result was a parking space that did not comply with the accessibility criteria. Lessons learned from the extensive project focusing on easily removed environmental barriers were that better communication and better clarity from the beginning would have supported the process. It was highly valuable to have on-site visits with AD staff during retrofits to discuss matters. The participants emphasized the importance of organizing retrofit measures and having a close dialogue with the businesses so that they understand what is going on, and that the retrofitting does not interfere with other aspects. For example, it is not helpful that all lifts are out of service at the same time. In addition, the greater the efforts, the more extended networks and communications are required.

3.3.3 Culture.

The building regulations and the law on human rights were reported as two cultures with different mindsets that meet each other in the AD Web-based platform. Some participants reflected upon how they had gained new knowledge during projects, but also that there was an increased awareness of equality in society. Basic assumptions in organizations or less questioning on issues have changed regarding accessibility issues during the projects, for example, when retrofits are relevant, justified and fair, especially among contractors and their staff.

A lack of team culture was mentioned as a critical barrier to an efficient retrofit strategy. For example, to avoid delays in the reconstruction phase, deviations from the building documents regarding accessibility were made. Sometimes other aspects than access, such as time, and costs were valued more than inclusion for all potential visitors. The participants emphasized the need for good arguments in such instances. The reasoning around challenging environmental barriers was also seen as a success, as it leads to organizational and individual learning. Decisions on not resolving barriers were viewed as giving up.

3.3.4 Implementation climate.

In a pre-study of assessing and informing about accessibility, several governmental agencies [National Property Board (Statens Fastighetsverk), 2014] concluded that the AD reports are supportive in terms of knowledge to analyze and plan measures to improve accessibility. However, the implementation climate varies as there are many organizations and individuals involved. In some geographical areas, the human rights movement has been a driving force, which can be seen as a success factor. Another success factor was that staff involved in retrofitting had gained knowledge and established the importance of doing it right from the start. The participants also reported that even if some individuals promoted retrofitting, they needed support during tough discussions, because other stakeholders did not agree. Some participants also reported that accessibility was not a priority for some individuals, but “deviation” from the accessibility requirements in the AD items was the first response.

3.3.5 Readiness for implementation.

Some participants highlighted that organizations might not have the resources to allow staff time for a system such as the AD on top of what they are already doing, without noticeably impacting other areas. With Web-based training, the possibility for continuous learning is better. To create resources, some formal partners collaborate with the Swedish Public Employment Service, and one participant reported that the municipal executive committee had allocated money for a three-year accessibility assessment project.

Longstanding cooperation with the disability council, formal partners, facility managers, accessibility assessors, businesses and visitors has meant knowledge accumulation, which has facilitated retrofitting. Major retrofits, such as lifts and WCs, were related to major costs and practical issues that might constitute barriers, which meant that they were delayed or not performed at all. Many organizations and individuals need to be coordinated, and the businesses also had different perspectives on which accessibility measures needs to be taken. Participants who had been part of the development reported the necessity of having political anchoring in what should be done and to have allocated resources. One participant reported that they thought it would be hundreds or a thousand measures that needed to be considered after an accessibility assessment of facilities within the organization, but the number was even more.

3.4 Characteristics of individuals

3.4.1 Knowledge and beliefs.

Participants noted that the AD earlier was organized under the unit of Human Rights Committee, but since 2020, it is organized within the regionally owned property management company. They reflected upon what differences it can make, to be closer to the property management and maybe far from a more social oriented division, but no conclusions were drawn. Increased awareness after being involved in projects led individuals to realize how important it is to ensure building access and inclusion from the beginning. There was a variety of individuals undertaking the assessments, sometimes the accessibility assessors were commissioned as consultants. Participants who had done several assessments themselves reported on the time-consuming inventory and immense subsequent work. However, they noted that individuals with previous experience and established routines need less time and effort.

Some participants reflected upon the complexity of accessibility and how difficult it was to make the information understandable for retrofitting and new construction. Trade-offs are sometimes necessary, and one participant lacked the opportunity for more pragmatic discussions. One participant said that as an assessor, you learn how to assess and generate AD reports, but the output is only a limited answer on how to comply with the objectives of the Swedish building regulations and current policies. Another participant expressed instead how people were supported by AD reports, and facility managers started to do things in the right way.

The participants reflected upon that the attitudes from the staff in the businesses sometimes were that retrofitting cause messy and noisy disturbances. In addition, facility managers initially often wanted to deviate from the AD item standard, but later accepted it. Due to poor understanding, they also experienced that sometimes it was extensive measures for what appear to be small changes and thereby cause negative response. Facility managers and maintenance operative staff do not always have persuasive arguments for why the measures should be done.

3.4.2 Self-efficacy.

Accessibility assessors engaged via the Swedish Public Employment Service sometimes had poor self-efficacy in doing the assessments. Others had high demands on themselves to do many assessments in a short period of time, which was something the supervisors must handle. One participant noted that experienced consultants doing assessments was efficient, because they had self-efficacy in their role as consultants and ability to judge the degree of access problems in various facilities. Consultants might also add knowledge, beliefs and creativity that increase the potentials for alternative retrofit solutions.

Some participants emphasized the importance of having access to expert knowledge to interpret the AD reports, because they did not have sufficient expertise themselves to suggest solutions.

3.4.3 Individual stage of change.

The participants reported different interest in accessibility issues, and in the interviews, some touched upon the variation in individual stage of change among all people working with the AD. Some participants, more than others, emphasized that learning by experience is important, both regarding assessments and retrofits, because accessibility issues are complex, and everyone must understand the context.

Individual stage of change was dependent on mandate, trust and if there were available pathways to knowledge. Some participants experienced their own limitations and emphasized the importance of involving other professions, because they have different knowledge. Trying to remove barriers has also led to the insight that many barriers are not easily removed. To improve accessibility, it was considered important to have a flexible approach without status differences. Together people with different knowledge can reflect and reason on what is possible or not.

3.4.4 Individual identification with organization.

Positive affective responses, success and changes lead to commitment with the organization. In addition, an important personal attribute reported was the capacity to see that the right competences are involved and collaborate so that silo-thinking is avoided.

3.5 Process

3.5.1 Planning.

Planning was reported as required to prepare and efficiently conduct assessments. The development of Web-based training and the use of smartphones and tablets for assessments have made efficient planning easier. Relevant work is done on-site and then finalized in the office. To reduce travel time and be cost-effective, some assessors reported that they go together to places and make the assessments. One participant reported that the high level of details makes assessments time consuming and thus hard to efficiently combine with other on-site tasks and regular work, even if the data for the AD Web-based platform is much easier to administer today.

Participants proposed that, ideally, during planned maintenance of buildings, project owners collect information and share it with facility managers and project coordinators to co-plan the execution. However, sometimes the objectives are vague, and it has been difficult for the staff to understand the reason to retrofit. A need for a more participatory approach to planning was highlighted. One of the main challenges reported when retrofitting was to reduce the negative consequences of a temporary construction site blocking access for the business or causing inconvenience for the individuals working in the environment. They must therefore be involved early in the process.

In one region, the board allocated money (about €8.7m) to remove all the identified barriers in a project. The process was vague from the beginning but developed during time. To manage all the issues, a strategy was developed to analyze and classify the issues into one of the four following categories:

  1. easily removed barrier;

  2. it is not reasonable to do it now (e.g. reconstruction is planned within some years);

  3. it is not economically defensible; and

  4. it is not an easily removed barrier.

They also emphasized the importance of documenting deviations. One participant claimed that today many facility managers sort and prioritize retrofits based on costs, like “low hanging fruit.” Instead, the participant emphasized, the goal must be the overall degree of accessibility and impact for visitors.

3.5.2 Engaging.

The participants were, to a different extent, engaged in the implementation. Some were implementation leaders, and others did the job they were asked to do. The individual formally appointed must keep together different aspects, clarify reported barriers and possible solutions as well as arrange site visits to increase the understanding. That is, a leader with experiences of the different perspectives on accessibility and explicit time dedicated to the task and not as a distraction on top of other job duties was considered as a factor for success. One participant pinpointed the importance of supporting the assessors, especially the young ones employed by the Swedish Public Employment Service. Success encouraged some participants to continue, especially when policy makers were keener to provide resources to keep up a good reputation. Collaboration across municipal administration facilities was also reported as a success factor. Sometimes the participants wished to have more support such as training activities with implementation leaders and access to arguments to convince others of the necessity to improve accessibility.

3.5.3 Executing.

Using Web-based training and smartphones made it easier to assess facilities. From a facility management perspective, the automatic AD reports facilitated the work to identify easily removed barriers but also identifying the complexity when retrofitting. Therefore, the need of certified accessibility experts was emphasized to guide the implementation of measures aiming to remedy identified barriers. Dialogue with a steering or reference group was suggested to reduce the risk of missing important aspects. In addition, some participants reported that identified accessibility issues could be integrated with other aspects in maintenance, reconstruction or conversion processes. Further, one participant reported that project leaders deviated from the plan to keep the entire project on schedule. Large projects were more challenging; at the same time, as they enabled overarching efforts in several facilities.

3.5.4 Reflecting and evaluating.

Assessing many details was reported to make AD assessments time consuming. When accessibility assessors identified bugs, they reported them to the AD staff. Participants with experience of the third version reported it as faster, more logical, manageable and transparent and thereby easier to administrate. This new version was reported to have clearer guidelines, improved information on objectives and no overload of information. For reliable visitor information as well as AD report results, the data available in the AD needs to be continuously updated, which is a responsibility for both the formal partners and the businesses.

The participants reflected upon lessons learned. For instance, to overcome the different perspectives from the beginning and during the facility management process. They mentioned all challenges to carry out the assessments and measures efficiently. Several referred to one extensive retrofit project that failed in several ways in the beginning. They consulted a certified accessibility expert to explain the barrier implications in practice. Despite being helpful, the measures nevertheless went wrong. Some participants asked for more participatory approaches and time to survey and debrief, before, during and after retrofitting. Maybe there was also too little effort on learning within the own organization. One participant emphasized the importance of taking notes of the reason for acting or not acting upon each identified barrier. A suggestion was to use the AD Web-based platform pedagogically to develop learning organizations, to avoid future failures and give continuous feedback to the facility managers. Several of the participants reflected upon the importance of collaboration between different professions to reach more accessible solutions and of evaluating the impacts each measure has for the visitors.

4. Discussion

The findings of this in-depth exploration report both what has facilitated and hindered the development and implementation of a Web-based accessibility tool for public facilities. Some issues are challenges that do not necessarily become barriers in the process if they are dealt with in a timely manner.

Overall, development and implementation of the AD is facilitated by communication and iterative processes within the inner as well as with the outer setting (see Figure 1). The AD user meetings in the inner setting are important for the continuous possibility to develop the intervention to upcoming needs. Important is also to anchor each step in the development process in the outer setting, i.e. anchor it locally, regionally and nationally, within public authorities as well as disability organizations. For facility management, the AD reports are an important part of the intervention characteristics. They offer different alternatives, due to the actual needs and local contextual factors at site, and thereby, they serve as a basis for identification of accessibility issues. To develop and implement an AD also poses challenges. Some of them are that many organizations and professionals are involved, to keep the information on the website updated and reliable and to collaborate and communicate accessibility issues in the entire process so that the retrofits in the end increase accessibility.

As the findings demonstrate, adequate inner-setting organizations are important, which consider the entirety of the built environment and allow for accessibility issues to take time. Interventions need to be developed continuously alongside with evaluations, especially when there is a high number of groups or organizational levels targeted by the intervention (Gray et al., 2014; Skivington et al., 2021). All with diverse values and intentions. Some might have their focus on human and social issues, whereas others’ focus is on regulatory and economic issues. From the start, the AD was organized within a sector, with a strong focus on human rights and then moved to the sector of facility management. However, no conclusions about what this meant could be drawn from this study, except the general importance to take human diversity into consideration throughout.

To keep the information on the website updated and reliable is a challenge and a common responsibility for the formal partners and the AD staff. It was pointed out by the participants that managing resources for facilitating the assessment of environmental barriers, as part of facility management, can be more effective with the use of technology (e.g. mobile devices, online meetings and automatic AD reports). Another way to allocate resources assessment of environmental barriers is the collaboration with the Swedish Public Employment Service to get young individuals far from the labor market as staff to conduct the assessments. The young assessors developed new skills and got new opportunities for entering the labor market, which is considered a win–win approach. Thus, creative solutions benefitting from advancement in science and technology as well as cross-boundary collaborations facilitate development and implementation.

One aspect of collaboration and communication around accessibility is the fragmentation of the building regulations into AD items. Accessibility issues cannot be seen in isolation as a list with barriers to remove but need to be considered as part of the visitors’ everyday activities (Bigonnesse et al., 2018); otherwise, there will be barriers for participation (Calder et al., 2018). Experts with competence that can balance different criteria and technical property requirements are required. Skilled and creative staff with previous experience of similar challenges are reported to facilitate retrofit reasoning and professional judgment. This shows that integrated education, communication and awareness-raising activities are of high importance.

Another aspect is that facility managers reported that the businesses did not always understand the reasons to retrofit, which is a challenge, but by means of the AD and other efforts, the visibility of accessibility issues in the society had raised awareness in their organizations. Profound knowledge about human functioning and diversity is as important when planning new constructions as for retrofitting. The categorization of target groups might affect the final design, such as categorization based on mobility, occupational roles, age or disability (Müller et al., 2021), and so, it is important to consider accessibility early in the intervention process. The AD reports and guidelines were considered as pedagogically clear by several of the participants and could help facility managers to give an overview of the overall accessibility on a detailed level. Also, the new AD reports addressing facility managers and businesses could support knowledge about the physical environment even more. A goal of universal design is to generate cost-efficient, attractive, durable and reliable solutions in the facilities that everyone can use easily and together (Steinfeld and Maisel, 2012). Trade-off balance, creative solutions, adjustable features and regulatory deviations to reach universally designed solutions is sometimes necessary, but then the decisions need to be formally documented. In this study, examples were given of barriers identified as easily removed from the beginning, but because drainage and other issues needed to be involved, easily removed barriers become more complex. In other situations, a single barrier was removed, but the result was not accessible. This shows the importance of key individuals with knowledge on accessibility, human functioning, diversity and implementation goals, in addition to knowledge about the function of the whole building. An effort with disability awareness exercises for 521 employees in a municipality in western Sweden showed increased knowledge and awareness toward accessibility among key individuals (Lundälv et al., 2020).

Our findings also highlight that older facilities and their chosen construction technology might require extensive work and be costly to retrofit, which means that there is a need for trade-offs, creative measures to avoid the problems and promote innovative solutions. However, the AD reports were considered to support the identification of easily removed environmental barriers without major investments. Some participants reported possible economic benefits of accessible buildings such as providing competitive advantages and values for businesses. For business, broadening the market for their facilities increase their competitiveness (Steinfeld and Maisel, 2012). In a scoping review on the conceptualization of economic benefits of accessible sites, Terashima and Clark (2021) found three main approaches: as market potential, as cost saving and as hypothetical return based on the visitors’ willingness to pay.

From a practical view, the organization of retrofits is also important because the measures taken affect the visitors. For example, it is not helpful that all lifts are out of service at the same time. Retrofits might also create difficulties for the businesses and remove a significant service and/or income. Consequently, constructing a facility with a high degree of accessibility right from the start is the ideal approach. Lessons learned from using the AD tool can contribute to such approaches.

4.1 Methodological reflections

The theoretical framework CFIR comprises general principles for implementation, which made it suitable for a directed content analysis of an accessibility intervention as well. Usually, the implementation of an evidence-based intervention is investigated in a particular setting and organization (Damschroder et al., 2009), but in this case, the development of the AD into several organizations was described. This means that experiences of previous versions were also in some of the participants’ minds and the inner setting could differ (e.g. who did the assessments); however, the changes over time and differences in organizations have been elucidated in the findings. Adding to the complexity is that the users of the intervention can choose if they just want to contribute information to visitors, or if they should receive AD reports on environmental barriers to improve accessibility. However, by using a theoretical framework, the facilitators and challenges are revealed, and the possibility to generalize and build on findings across studies and contexts are supported.

This study was carried out in a Swedish context, with accessibility goals characterized by western norms. In other places and cultures, facilitators and challenges, as well as strategies for implementation, might differ or need to be adapted.

5. Conclusions

It is important to support increased accessibility and use of the built environment. Otherwise, opportunities for integration are lost when people are excluded from public buildings and specific facilities (Ormerod and Newton, 2005). The findings of how the AD with detailed information about the public environment has been developed and implemented as a tool for facility managers is an example of how an intervention can be systematically explored, providing insights and lessons learned both on success factors and challenges. Such insights and lessons learned are useful when striving to reach the intended goal of accessible public facilities. The AD can be an important facilitator to identify the environmental barriers, whereas expert knowledge is needed to plan for accessible solutions and retrofits. The utility of the AD could be improved by including a feature that provides suggestions and examples of how specific accessibility issues detected in a facility can be addressed or resolved. Moreover, such suggestions and examples could support cost–benefit analysis both on facility and societal levels, which can provide reasons for facility owners as well as policy makers to take tangible measures to enhance accessibility.


The AD context visualized in the five domains of the CFIR, with inspiration from Damschroder et al. (2009). The irregular-shaped depiction implies that the five domains interact in complex and multi-faceted ways, and that the lines between them are not always clear

Figure 1.

The AD context visualized in the five domains of the CFIR, with inspiration from Damschroder et al. (2009). The irregular-shaped depiction implies that the five domains interact in complex and multi-faceted ways, and that the lines between them are not always clear

Domains and constructs of the CFIR and domain-related quotes from participants (translated from Swedish)

Domain Domain-related quote Construct
Intervention characteristics (Section 3.1) The strength of the AD lies precisely in the fundamental aim of showing individuals what the physical environment looks like. I think that is a very good function, and I would like to see even more development of the AD to assure its quality. (…) but [the building legislation] is not formulated as zoomed-in detailed building design requirements … and the legislation requires a competency to balance different technical property requirements (Architect)
It is very good that you get these reports about easily resolved barriers, and what can be done about them, […] so that has really made things easier for the facility management side (Municipality official 1)
Intervention source (Section 3.1.1)
Evidence strength and Quality (Section 3.1.2)
Relative advantage (Section 3.1.3)
Adaptability and trialability (Section 3.1.4)*
Complexity (Section 3.1.5)
Design Quality and Packaging (Section 3.1.6)
Cost (Section 3.1.7)
Outer Setting (Section 3.2) When they [the property owners] get a list of measures, they go through them based on costs. They often then, as a first step, pick the measures that are the lowest hanging fruits, so to speak (Urban planning consultant)
(…) to actually meet all the current requirements, it’s a good start. And it’s clear that in that regard […] it’s a very quick check whether you deviate from some regulations in some respect, so to speak (Municipality official 2)
Client needs and resources (Section 3.2.1)**
Cosmopolitanism and peer pressure (Section 3.2.2)*
External policies and incentives (Section 3.2.3)
Inner setting (Section 3.3) (…) like I said before, to find someone who ties the collaboration together from the beginning … and that depends a lot on the individual, of course … what kind of basic attitude you have (Head of real estate company)
No one could have missed the fact that this is a problem if we don’t get it right from the start (Head of real estate company)
Structural characteristics (Section 3.3.1)
Networks and communications (Section 3.3.2)
Culture (Section 3.3.3)
Implementation climate (Section 3.3.5)***
Readiness for implementation (Section 3.3.5)***
Characteristics of individuals (Section 3.4) You don’t have the evidence […] as a manager […] we would have needed some sort of support when there are these tough discussions with the businesses that don’t want us to go in, and it might cause a loss of production for them (Facility manager 1)
As I hope I expressed before, I think there is such a level of awareness, and it is much greater now than before (Facility manager 2)
Knowledge and beliefs (Section 3.4.1)
Self-efficacy (Section 3.4.2)
Individual stage of change (Section 3.4.3)
Individual identification with organization (Section 3.4.4)
Process (Section 3.5) And then a routine was created for deviations away from accessibility. The idea was that you would also clear up those issues by having the accessibility expert look at possible collisions, or whether there was any reason why you could not achieve the accessibility requirements that were set (Project manager)
(…) but I think it’s important that this [the AD] exists, as I said, and then I don’t really see any limits on how much further you can develop it. The foundation has been laid, so that essentially […] both technically and in terms of content, it should be possible to further develop it, I believe, absolutely (Municipality official 2)
Planning (Section 3.5.1)
Engaging (Section 3.5.2)***
Executing (Section 3.5.3)
Reflecting and evaluating (Section 3.5.4)

The selected quotes were coded to the italicized constructs.

*Two constructs in CFIR were merged into one for the purpose of this study.

**Patient in CFIR was changed to Client for the purpose of this study.

***Construct including subconstructs in CFIR. Subconstructs were not used for the purpose of this study

Source: Authors’ own creation


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Thanks to the staff at the Tillgänglighetsdatabasen, who introduced the authors to the database and provided with them with documents, and thanks to the individuals who participated in the interviews. The work was conducted within the context of the Center for Aging and Supportive Environments (CASE) at Lund University.

Funding: This project was supported with funding from the Swedish funding agency Formas (Number 2019–00533).

Conflicts of interest/competing interests: The authors do not have any conflicts of interest.

Corresponding author

Gunilla Carlsson can be contacted at: gunilla.carlsson@med.lu.se

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